Effects of anisometropic amblyopia on visual cognitive functions in children.

Background: To investigate visual cognitive functions, including visual attention, executive function, and visual working memory, in children with anisometropic amblyopia versus those with normal vision.

Methods: Thirty-five children with anisometropic amblyopia and 34 with normal vision participated. Visual acuity, stereoacuity, and contrast sensitivity were measured, followed by the Cambridge Neuropsychological Test Automated Battery's six subtests for cognitive evaluation. Visual attention was assessed using reaction time (RTI) and rapid visual information processing (RVP). Executive function was evaluated through the multitasking test (MTT). Visual working memory was assessed with spatial working memory (SWM), delayed matching to sample (DMS), and paired association learning (PAL), all under binocular conditions.

Results: The amblyopia group exhibited longer reaction and movement times in the RTI than the control group (p < 0.01). A trend towards lower RVP A' scores, reflecting reduced ability to detect target sequences, appeared in the amblyopia group (p = 0.056). Amblyopic children demonstrated a lower multitasking cost in the MTT compared with the control group (p = 0.04). As difficulty increased in the SWM (from four to six boxes), amblyopic children revisited more (p = 0.01). In the DMS task, while no differences were observed across all delay times (p = 0.55), amblyopic children performed significantly worse than the control group under the 12-second delay (p = 0.04). In the eight-pattern PAL condition, the amblyopia group made more errors (p = 0.01).

Conclusions: Children with anisometropic amblyopia performed poorly on neuropsychological tests, particularly visual attention and working memory, but outperformed the control group in multitasking. These findings highlight the broader cognitive impacts of anisometropic amblyopia beyond vision.